who’s having the hard time?

I’ve been invited to speak to the Weill Cornell Hospital Department of Geriatrics, so I’ve been reviewing my interviews with people in the field. Eighteen months ago I much enjoyed meeting geriatric care manager Claudia Fine, and today I was struck by her description of her sister’s difficulty dealing with her mother-in-law’s dementia.

“It’s true Dorothy didn’t fall asleep and wake up dead,” Fine observed dryly. Instead, she’s undergone what geriatricians consider a fairly predictable, non crisis-laden decline. “She loves being in the park, the leaves, likes the sound of the rustle. She motions upward, says ‘the the, the the.’ It’s upsetting to my sister-in-law that she can’t find the words. She says, ‘This is so terrible, so tragic, I can’t stand being with her.’ That’s the operative thing,” Fine continued. “Why can’t she stand being with her? She can’t tolerate the fact that her mother-in-law isn’t the way she was. But Dorothy’s obviously very happy.”

Cognitive decline, beloved personhood slipping away, can be more painful to witness than to undergo. The hard but necessary tasks for those who remain on shore are to change our expectations, to reassess what activities (holding a doll, perhaps, or pushing a shopping cart) qualify as meaningful, to focus not on what is lost but what remains, and to find pleasure where we can, as Dorothy does in the leaves overhead. Which brings my beloved 94-year-old godmother to mind. Memory loss has her on a three-minute loop, and it’s growing smaller all the time. It’s wretched for her caregivers, but she’s not suffering. She knows me, and the characteristics I love best – imagination, humor, courage – are still there, along with the imperiousness and self-indulgence that have always made her a pain in the ass. The conversation has changed from art and politics to imaginary landscapes, but I’m still available to her and she to me, and that remains a source of joy for both of us.